PREVENTIVE LUNG CANCER SCREENINGS COMING SOON

Dr. Norman H. Edelman of the American Lung Association said that until now there has been no consistent standard of care for lung cancer screenings. Some doctors already order CT scans if they suspect cancer, while others don’t. Some, he said, still use traditional X-rays even though they have been shown to be inferior to CT scans.

“For sure it’s done, but it’s not part of anybody’s standard of care,” Edelman said. “You won’t find it in any of the guidelines of any professional society.”

Who pays for the scans is a big part of the implementation puzzle. A spokesperson with the U.S. Department of Health and Human Services said the Affordable Care Act of 2010 requires insurance companies to cover all preventive services that the task force gives an “A” or “B” rating.

Because the task force rated the lung cancer scans a B, insurance companies would be required to provide the service one year after it is given final approval, which is expected to occur in three to six months.

The task force uses a panel of independent medical experts to make recommendations about which preventive services are worthy of widespread adoption. Those given the highest A rating include blood typing and antibody testing for pregnant women, blood pressure screening for adults and colorectal cancer screening.

The timetable would mean that insurance companies would probably not be required to cover the scans until 2015 at the earliest, but some are already on board with the change.

An Aetna spokeswoman said in an email that the company would cover the scans within 60 days of final approval. A Health Net spokeswoman said the company would comply as quickly as possible after a final decision, though some plans for 2014 have already been filed with regulators, so changing them might be difficult.

Sharp Chula Vista is offering a cash option, an out-of-pocket fee of about $300, for patients whose insurance does not cover screening.

While screening has been shown conclusively to increase a smoker’s chances of survival, Edelman, the American Lung Association doctor, noted that a 20 percent improvement in survivability still leaves 80 percent who die from lung cancer.

“The important thing is, let’s not say, ‘OK, we can stop all smoking cessation efforts.’ Stopping smoking is still the most effective way to stop lung cancer,” he said.